Why men also need to take care of their pelvic floor

When it comes to pelvic floor health, most people think it's only a concern for women. For decades, studies have focused on the effects of pregnancy, childbirth, and menopause on this essential muscle, responsible for supporting organs such as the bladder, uterus, and rectum. However, there's one group whose pelvic health is still neglected: men.

The pelvic floor is as important to men's health as it is to women's. In both cases, these muscles support the bladder, urethra, rectum, and prostate. It's estimated that about one in five men suffers from some form of pelvic dysfunction, a much higher number than previously thought.

The problem begins with a lack of information on the subject. While women learn about the pelvic floor from an early age, men generally only discover its existence when symptoms arise and often receive inaccurate diagnoses.

The main warning signs of problems in this area include urinary leakage, difficulty starting or maintaining a urinary stream, pain in the perineal region (between the anus and the testicles), discomfort during erection or ejaculation, constipation, and a feeling of incomplete evacuation. Many of these symptoms are attributed to infections, prostate problems, or even emotional issues.

"The pelvic floor muscles are essential for urinary and fecal continence, and are directly linked to erectile and ejaculatory function, as well as proper bowel function. When they are weakened, overly tense, or uncoordinated, symptoms arise that can seriously compromise a man's quality of life," explains urologist Leonardo Borges of Einstein Hospital Israelita.

According to him, many men live with these symptoms for months or even years without seeking help—whether out of ignorance, shame, or because they believe the problem has no solution. "This leads to delays in diagnosis and initiation of treatment," says Borges.

It's not just a problem for the elderly

A study published in the Journal of Women's & Pelvic Health Physical Therapy highlights the lack of information on the topic. Conducted with 479 men, the study revealed that 32% of participants aged 25 to 34 reported some type of urinary dysfunction. This finding contradicts the common belief that pelvic floor problems are exclusive to older men.

The study also identified a link between pelvic floor dysfunction and factors such as smoking, mental health, and socioeconomic status. "Historically, studies have focused on women. But it's now clear that men also suffer from pelvic floor dysfunction, including younger men, especially in contexts of stress, sedentary lifestyles, or postoperatively," analyzes the Einstein urologist.

Most male pelvic floor dysfunctions occur when there is a muscle imbalance: either the muscles are too loose (as in men who have had prostate surgery) or they are excessively tight, as a result of chronic stress, a sedentary lifestyle, poor posture, or impact activities.

"Emotional stress can generate chronic muscle tension in the pelvis, which hinders basic functions such as urinating, defecating, or maintaining an erection. A sedentary lifestyle, especially in those who spend long periods sitting, can compromise circulation and lead to muscle weakness or shortening. For this reason, a thorough physical evaluation and encouragement of more active habits should be encouraged in these patients," advises the doctor.

Activities like cycling, when practiced without proper care, can also affect the pelvic region by generating constant compression on local nerves and muscles. "You don't need to avoid sports, but you should practice them under professional guidance," emphasizes Leonardo Borges.

Diagnosis and treatment

The diagnosis of pelvic floor dysfunction is primarily clinical, based on the patient's history and physical examination. In some cases, additional tests such as urodynamics, perineal ultrasound, or pelvic MRI may be requested to confirm the clinical suspicion.

Although a urologist is usually the first professional to seek, successful treatment often depends on multidisciplinary work, involving specialized physiotherapists. "Male pelvic physiotherapy is one of the key allies in this process. Treatment may include exercises to strengthen weakened muscles and relaxation techniques for overly tense structures. The earlier it begins, the better the results. The key is to correctly identify the type of dysfunction, which requires a specialized evaluation," notes the specialist.

It's also possible to prevent problems with small lifestyle changes. These include avoiding long-term urinary retention, treating chronic constipation, correcting posture, taking breaks after prolonged sitting, maintaining a healthy weight, and avoiding excessive strain when lifting weights. Whenever possible, it's worth practicing specific pelvic floor exercises, such as Kegels, which essentially involve voluntarily contracting and relaxing the pelvic floor muscles. Seek professional guidance for this.

New guidelines

The importance of this topic is gaining recognition. In April of this year, the American Urological Association published new guidelines recommending that physicians be alert to pelvic dysfunction in men and refer patients for physical therapy when necessary. The document reflects a shift in the way men's health is being approached.

For Leonardo Borges, the most important warning is that men stop suffering in silence. "When a man experiences pain, urinary incontinence, or sexual dysfunction, it directly affects his self-esteem, identity, and quality of life. Increasing awareness on this topic is crucial so that he understands that taking care of his pelvic floor health is also part of self-care. Actions in this regard should be encouraged and viewed positively," concludes the urologist.

Source: Einstein Agency

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